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DSM staff profile

Dr John Woodfield

PositionSenior Lecturer
DepartmentDepartment of Surgical Sciences (Dunedin)
QualificationsMBChB(Otago) DTM&H(Liverpool) PhD(Otago) FRACS
Research summaryMeasuring and preventing complications, improving fitness before surgery, colorectal surgery, clinical audit, medical care in resource poor settings
Teaching
  • Convenor of ALM6 rotation in surgery
  • Clinical teaching of ALM4 students
  • ELM2 Integrated Cases tutor
Memberships
  • Member, Royal Australasian College of Surgeons
  • Member, Colorectal Surgical Society of Australia and New Zealand
ClinicalGeneral and colorectal surgery including colorectal cancer and IBD surgery, laparoscopic surgery, and colonoscopy

Research

My research interests include:

  1. High Intensity Interval Training (HIIT) to optimise fitness before major abdominal surgery: We have completed a RCT showing significant improvement in fitness and clinically relevant improvement in clinical outcomes. Current projects include optimising HIIT protocols in patients with medical comorbidities and a RCT comparing prehabilitation with HIIT in the hospital, home and the community.
  2. Low anterior resection syndrome (LARS) after anterior resection: We have completed a database of LARS after anterior resection for cancer at Dunedin Hospital. We are currently performing a cross over study assessing the importance of bile acid malabsorption, and have prospective studies planned assessing bacterial overgrown and the role of pelvic floor biofeedback physiotherapy with the ‘Contrain’ device.
  3. Complications after surgery. We are using a validated patient-centred questionnaire developed in our department to identify postoperative problems. Recent published work looks at complications that develop up to six weeks after surgery, and on the impact of incisional surgical site infections on patients. Previous work has examined the accuracy of clinical prediction of complications (and if this can be improved) and the role of prophylactic antibiotics.
  4. Audit and surgical outcomes: I am a co-director of the Otago Clinical Audit. OCA has documented all surgical procedures and complications at Dunedin for over 30 years. We are updating the program, and also use the data to support research and quality control initiatives within the Department of Surgery.
  5. Using ehealth to support patients on their surgical journey: We have partnered with SHI Global, a NZ based ehealth company to develop surgical care packs on an internet based software platform called Go Well Health. This supports patients through the process of diagnosis, prehabilitation, surgical care and convalescence in the community. Current work includes collaborating with the Kōhatu, Centre for Hauora Māori at the University of Otago to codesign the platform and to develop a total colorectal cancer pathway on-line. A series of pilot studies followed by a study to assess the impact of GWH on clinical outcomes are planned.
  6. Bowel preparation in elective colorectal surgery: We have completed a network meta-analysis on different methods of bowel preparation before elective colorectal surgery which was recently published in JAMA surgery. Future work will assess the impact of oral and intravenous antibiotics and mechanical bowel preparation on the microbiome.
  7. Improving outcomes associated with loop ileostomy: We are currently working with ‘The Insides Company’ in a RCT using a novel refeeding device to feed patients down the distal limb of their loop ileostomy before closure. Other recent studies have compared methods of loop ileostomy closure, and the impact of delay in closure on complications and length of stay.
  8. Working with collaborative research network: Including with STRATA assessing appendicitis in rural and urban patients and with the DISCO (surgical prehabilitation) and LARS international collaborative groups.
  9. Medical care in resource poor settings: Having worked in rural Africa as a surgeon for seven years I am interested in medical care in resource poor settings and have been involved in studies looking at trauma, tuberculosis (including the role of lymph node biopsy in diagnosing tuberculosis) and infertility

Other colorectal and general surgical projects that are ongoing or have recently been completed include:

  • Preventing ileus in elective colorectal surgery: A RCT assessing the role of prucalopride has recently been completed
  • ERAS in colorectal surgery
  • VRAM flap after abdominoperineal excision
  • Should surveillance colonoscopy be continued after the age of 75 in patients who have previously been treated for colorectal cancer?
  • The role of aspirin in treating colorectal cancer – the ASCOLT study
  • Case studies in surgery illustrating clinically relevant issues
  • Models assessing bowel damage during colonoscopy

Publications

Woodfield, J. C., Clifford, K., Schmidt, B., & Thompson-Fawcett, M. (2022). Has network meta-analysis resolved the controversies related to bowel preparation in elective colorectal surgery? Colorectal Disease. Advance online publication. doi: 10.1111/codi.16194

Turner, G. A., Clifford, K. A., Holloway, R., Woodfield, J. C., & Thompson-Fawcett, M. (2022). The impact of prolonged delay to loop ileostomy closure on postoperative morbidity and hospital stay: A retrospective cohort study. Colorectal Disease, 24, 854-861. doi: 10.1111/codi.16095

Woodfield, J. C., Clifford, K., Wilson, G. A., Munro, F., & Baldi, J. C. (2022). Short-term high-intensity interval training improves fitness before surgery: A randomised clinical trial. Scandinavian Journal of Medicine & Science in Sports, 32, 856-865. doi: 10.1111/sms.14130

Woodfield, J. C., Clifford, K., Schmidt, B., Turner, G. A., Amer, M. A., & McCall, J. L. (2021). Strategies for antibiotic administration for bowel preparation among patients undergoing elective colorectal surgery: A network meta-analysis. JAMA Surgery. Advance online publication. doi: 10.1001/jamasurg.2021.5251

Hart, A., Furkert, C., Clifford, K., & Woodfield, J. C. (2021). Impact of incisional surgical site infections on quality of life and patient satisfaction after general surgery: A case controlled study. Surgical Infections, 22(10), 1039-1046. doi: 10.1089/sur.2021.033

Turner, G. A., Clifford, K. A., Holloway, R., Woodfield, J. C., & Thompson-Fawcett, M. (2022). The impact of prolonged delay to loop ileostomy closure on postoperative morbidity and hospital stay: A retrospective cohort study. Colorectal Disease, 24, 854-861. doi: 10.1111/codi.16095

Journal - Research Article

Woodfield, J. C., Clifford, K., Wilson, G. A., Munro, F., & Baldi, J. C. (2022). Short-term high-intensity interval training improves fitness before surgery: A randomised clinical trial. Scandinavian Journal of Medicine & Science in Sports, 32, 856-865. doi: 10.1111/sms.14130

Journal - Research Article

Hart, A., Furkert, C., Clifford, K., & Woodfield, J. C. (2021). Impact of incisional surgical site infections on quality of life and patient satisfaction after general surgery: A case controlled study. Surgical Infections, 22(10), 1039-1046. doi: 10.1089/sur.2021.033

Journal - Research Article

Mallard, S. R., Clifford, K. A., Park, R., Trainee Intern Research Group, Cousins, K., Patton, A., Woodfield, J. C., & Thompson-Fawcett, M. (2021). Role for colorectal teams to support non-colorectal teams to improve clinical outcomes and adherence to ERAS guidelines for segmental colectomy: A cohort study. BMC Surgery, 21(1), 132. doi: 10.1186/s12893-021-01149-8

Journal - Research Article

Woodfield, J. C., Clifford, K., Schmidt, B., Turner, G. A., Amer, M. A., & McCall, J. L. (2021). Strategies for antibiotic administration for bowel preparation among patients undergoing elective colorectal surgery: A network meta-analysis. JAMA Surgery. Advance online publication. doi: 10.1001/jamasurg.2021.5251

Journal - Research Article

Keane, C., O'Grady, G., Bissett, I., & Woodfield, J. (2020). Comparison of bowel dysfunction between colorectal cancer survivors and a non-operative non-cancer control group. Colorectal Disease, 22, 806-813. doi: 10.1111/codi.14966

Journal - Research Article

Lord, I., Reeves, L., Gray, A., Woodfield, J., Clifford, K., & Thompson-Fawcett, M. (2020). Loop ilesotomy closure: A retrospective comparison of three techniques. ANZ Journal of Surgery, 90(9), 1632-1636. doi: 10.1111/ans.15922

Journal - Research Article

Johnson, S., Schultz, M., Scholze, M., Smith, T., Woodfield, J., & Hammer, N. (2019). How much force is required to perforate a colon during colonoscopy? An experimental study. Journal of the Mechanical Behavior of Biomedical Materials, 91, 139-148. doi: 10.1016/j.jmbbm.2018.11.024

Journal - Research Article

Woodfield, J., Deo, P., Davidson, A., Chen, T. Y.-T., & van Rij, A. (2019). Patient reporting of complications after surgery: What impact does documenting postoperative problems from the perspective of the patient using telephone interview and postal questionnaires have on the identification of complications after surgery? BMJ Open, 9(7), e028561. doi: 10.1136/bmjopen-2018-028561

Journal - Research Article

Woodfield, J. C., Sagar, P. M., Thekkinkattil, D. K., Gogu, P., Plank, L. D., & Burke, D. (2017). Accuracy of the surgeons' clinical prediction of postoperative major complications using a visual analog scale. Medical Decision Making, 37(1), 101-112. doi: 10.1177/0272989x16651875

Journal - Research Article

Woodfield, J., Hulme-Moir, M., & Ly, J. (2017). A comparison of the cost of primary closure or rectus abdominis myocutaneous flap closure of the perineum after abdominoperineal excision. Colorectal Disease, 19(10), 934-941. doi: 10.1111/codi.13690

Journal - Research Article

Woodfield, J. C., Jamil, W., & Sagar, P. M. (2016). Incidence and significance of postoperative complications occurring between discharge and 30 days: A prospective cohort study. Journal of Surgical Research, 206(1), 77-82. doi: 10.1016/j.jss.2016.06.073

Journal - Research Article

Houlden, C., & Woodfield, J. (2015). The validity of the macroscopic appearance of lymph node biopsy in the diagnosis of tuberculosis. Tropical Doctor, 45(4), 221-224. doi: 10.1177/0049475515586501

Journal - Research Article

Woodfield, J. C., Beshay, N., & van Rij, A. M. (2009). A meta-analysis of randomized, controlled trials assessing the prophylactic use of ceftriaxone: A study of wound, chest, and urinary infections. World Journal of Surgery, 33(12), 2538-2550. doi: 10.1007/s00268-009-0158-4

Journal - Research Article

Sagar, P. M., Thekkinkattil, D. K., Heath, R. M., Woodfield, J., Gonsalves, S., & Landon, C. R. (2008). Feasibility and functional outcome of laparoscopic sacrocoporectopexy for combined vaginal and rectal prolapse. Diseases of the Colon & Rectum, 51(9), 1414-1420. doi: 10.1007/s10350-008-9371-8

Journal - Research Article

Woodfield, J. C., Chalmers, A. G., Phillips, N., & Sagar, P. M. (2008). Algorithms for the surgical management of retrorectal tumours. British Journal of Surgery, 95(2), 214-221. doi: 10.1002/bjs.5931

Journal - Research Article

Woodfield, J. C., Beshay, N. M. Y., Pettigrew, R. A., Plank, L. D., & van Rij, A. M. (2007). American Society of Anesthesiologists classification of physical status as a predictor of wound infection. ANZ Journal of Surgery, 77, 738-741.

Journal - Research Article

Woodfield, J. C., Pettigrew, R. A., Plank, L. D., Landmann, M., & van Rij, A. M. (2007). Accuracy of the surgeons' clinical prediction of perioperative complications using a visual analog scale. World Journal of Surgery, 31, 1912-1920.

Journal - Research Article

Woodfield, J. C., Parry, B. I., Bissett, I. P., & McKee, M. (2006). Experience with the use of vacuum dressings in the management of acute enterocutaneous fistulas. ANZ Journal of Surgery, 76(12), 1085-1087. doi: 10.1111/j.1445-2197.2006.03956.x

Journal - Research Article

Abbas, S. M., Bissett, I. P., Holden, A., Woodfield, J. C., Parry, B. R., & Duncan, D. (2005). Clinical variables associated with positive angiographic localization of lower gastrointestinal bleeding. ANZ Journal of Surgery, 75(11), 953-957. doi: 10.1111/j.1445-2197.2005.03582.x

Journal - Research Article

Woodfield, J. C., van Rij, A. M., Pettigrew, R. A., van der Linden, A., & Bolt, D. (2005). Using cost of infection as a tool to demonstrate a difference in prophylactic antibiotic efficacy: A prospective randomized comparison of the pharmacoeconomic effectiveness of ceftriaxone and cefotaxime prophylaxis in abdominal surgery. World Journal of Surgery, 29, 18-24.

Journal - Research Article

Koea, J., Rodgers, M., Thompson, P., Woodfield, J., Holden, A., & McCall, J. (2004). Laparoscopy in the management of colorectal cancer metastatic to the liver. ANZ Journal of Surgery, 74(12), 1056-1059. doi: 10.1111/j.1445-1433.2004.03267.x

Journal - Research Article

Mittal, A., Windsor, J., Woodfield, J., Casey, P., & Lane, M. (2004). Matched study of three methods for palliation of malignant pyloroduodenal obstruction. British Journal of Surgery, 91(2), 205-209. doi: 10.1002/bjs.4396

Journal - Research Article

Otieno, T., Woodfield, J. C., Bird, P., & Hill, A. G. (2004). Trauma in rural Kenya. Injury, 35(12), 1228-1233. doi: 10.1016/j.injury.2004.03.013

Journal - Research Article

Woodfield, J. C., Windsor, J. A., Godfrey, C. C., Orr, D. A., & Officer, N. M. (2004). Diagnosis and management of isolated pancreatic tuberculosis: Recent experience and literature review. ANZ Journal of Surgery, 74(5), 368-371. doi: 10.1111/j.1445-1433.2004.02996.x

Journal - Research Article

Hill, A. G., & Woodfield, J. C. (2003). Thinking outside the box. ANZ Journal of Surgery, 73(11), 881-883. doi: 10.1046/j.1445-1433.2003.02716.x

Journal - Research Article

Woodfield, J. C., van Rij, A. M., Pettigrew, R. A., van der Linden, A. J., Solomon, C., & Bolt, D. (2003). A comparison of the prophylactic efficacy of ceftriaxone and cefotaxime in abdominal surgery. American Journal of Surgery, 185, 45-49.

Journal - Research Article

Woodfield, J. C., Clifford, K., Schmidt, B., & Thompson-Fawcett, M. (2022). Has network meta-analysis resolved the controversies related to bowel preparation in elective colorectal surgery? Colorectal Disease. Advance online publication. doi: 10.1111/codi.16194

Journal - Research Other

Keane, C., Fearnhead, N. S., Bordeianou, L., Christensen, P., Espin Basany, E., Laurberg, S., … on behalf of the LARS International Collaborative Group, including Eglinton, T., & Woodfield, J. (2020). International consensus definition of low anterior resection syndrome. Colorectal Disease, 22(3), 331-341. doi: 10.1111/codi.14957

Journal - Research Other

Becker, D., & Woodfield, J. (2019). Complicated appendicitis within an incisional hernia. ANZ Journal of Surgery, 89(6), E270-E271. doi: 10.1111/ans.14339

Journal - Research Other

Woodfield, J. C., Baldi, J. C., & Clifford, K. (2019). What is the minimal dose of HIIT required to achieve pre-operative benefit. Scandinavian Journal of Medicine & Science in Sports, 29, 1841. doi: 10.1111/sms.13538

Journal - Research Other

Turner, G. A., & Woodfield, J. C. (2018). Stercoral perforation of the blind end of a side-to-end colorectal anastomosis. ANZ Journal of Surgery, 88(5), E478. doi: 10.1111/ans.14291

Journal - Research Other

Woodfield, J., Zacharias, M., Wilson, G., Munro, F., Thomas, K., Gray, A., & Baldi, J. (2018). Protocol, and practical challenges, for a randomised controlled trial comparing the impact of high intensity interval training against standard care before major abdominal surgery: Study protocol for a randomised controlled trial. Trials, 19(1), 331. doi: 10.1186/s13063-018-2701-9

Journal - Research Other

Taylor, S. G., van Rij, A. M., & Woodfield, J. C. (2016). Duodenal obstruction associated with an abdominal aortic aneurysm. Journal of Vascular Surgery Cases & Innovative Techniques, 2(3), 134-136. doi: 10.1016/j.jvscit.2016.05.008

Journal - Research Other

Woodfield, J. C., & van Rij, A. M. (2008). Reply. World Journal of Surgery, 32, 326-327. doi: 10.1007/s00268-007-9296-8

Journal - Research Other

Woodfield, J. C., & Windsor, J. A. (2006). Spilled gallstones cannot be ignored. American Journal of Surgery, 192(2), 270-271. doi: 10.1016/j.amjsurg.2005.08.004

Journal - Research Other

Ronald, M., Woodfield, J., McCall, J., & Koea, J. (2004). Hepatic adenomas in male patients. HPB, 6(1), 25-27. doi: 10.1080/13651820310020846

Journal - Research Other

Woodfield, J. C., Rodgers, M., & Windsor, J. A. (2004). Peritoneal gallstones following laparoscopic cholecystectomy: Incidence, complications, and management. Surgical Endoscopy, 18, 1200-1207. doi: 10.1007/s00464-003-8260-4

Journal - Research Other

Woodfield, J., & Koea, J. (2003). Acute right upper quadrant pain and anaemia [Medical image]. New Zealand Medical Journal, 116(1174). Retrieved from https://journal.nzma.org.nz/

Journal - Research Other

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